Member

Will residency programs put aside one bad semester when evaluating a student?

Just wanting to know if anyone out there has started med school out with a horrible semester, and turned it around, and suceeded (or is currently suceeding).

My first semester has been a huge adjustment period. I don't think I will survive (mentally) for the next four years by barely staying above passing, so I am already looking ahead to next semster as the starting point of my new life as a medical student.

I NEED some "come from behind victory stories" to give me some motivation. Details about how you changed your life (study habits, etc...) would be greatly appreciated. Anyone have any?

P.S. You can exaggerate your story a little bit to make it more of a motivational speech to me...believe me, I will never know.

Senior Member

I'm wondering about the same thing, as I had aspirations of getting into a competetive specialty (orthopedic surgery) when I started medical school, but this semester hasn't really gone that well (see my post "studying for big picture types"). I've had a hard time adjusting to medical school and I have to admit that my undergraduate preparation was not that great. Up until this point I've gotten by on intelligence and especially ability to take standardized tests, both of which are great but won't help much in medical school if you aren't studying properly. Anyway, if I can get things turned around and make excellent grades from here on out and kill the boards will residency program directors (in competetive specialties) be able to look past my miserable first semester? I know there are a lot of other factors involved (letters, research, etc.) but will the be able to overlook a one semester blip in my academic record?

One more thing. I don't really know exactly how the whole AOA thing works, but I've been told it's almost a prerequisite for some specialties. Anyway, I'm worried that I've already ruined any chance of being in the top 10-20% of my class even if I made A's from here on out (although I don't really know). If my first semester was the only thing that kept me out of AOA would programs that almost require AOA status be able to overlook it?

Senior Member

Pre-clinical grades are not all that important come time for residency selection. However, they do figure into AOA, which is necessary for some of the more competitive specialties, ala Derm, Ortho, etc. If you rock the 3rd year, as well as Step 1, and pick up the pace for the rest of your pre-cinical courses, I don't see why you couldn't land an ortho residency. It may not be at your top choice, but you'd still get to be an orthopedic surgeon.

Bottom line is this: If you don't wanna do something insanely competitive, just focus on passing everything the first two years. However, if you're hell bent on a neurosurgery, derm, ortho, ENT, or plastics residency, then you shouldn't be reading this post, you should be studying!

it's a hard life...

The problem with medical school is that you take the top performers from universities all over the country, then put them in a class to compete against each other. It's like going to the Olympics - everybody is a superstar. Unfortunately, we are all used to being honor students, and it's a hard blow when you find yourself in the middle of the pack - probably for the first time in your life.

I had a hard first YEAR. My dad was diagnosed with terminal cancer right when I started med school. My first year was just a blur of trying to cope. I very nearly failed anatomy outright - if I'd gotten one point less on the final, I would've had to repeat. I did a lot better second year, after he passed away, but I was still about top quartile of the class at the most. Clinical years I had a couple honors, couple letters, couple passes. Boards were 222 and 242 for I and II respectively.

When I interviewed for surgery positions, not a single PD ever once asked a single thing about my first year - or my second year for that matter. I think by that point it would be like a med school adcom asking about your high school grades: it was a long time ago and they have more important things to think about. Yeah, if you sail through you're more likely to get AOA, but that's one accolade in the background of the entirety of your performance. If you got it: great, flaunt it. Most folks don't, of course.

I was pretty heavily pursued by several programs - personal phone calls, promises that I was their 'number one rank', etc., and I got my first choice in the match.

Work hard, do your best, be honest. This is a looong haul you're in for. You'll have ups and downs.

best of luck,
-ws

Patience is a virtue. Virtues are strengthened - like muscles - by exercise. When you ask God for patience, he doesn't give you patience - he gives you plenty of situations in which you can exercise patience.

it's a hard life...

Well, I'm sure it's not against the law. Does it violate some term in the match agreement? I don't know, to be honest. I know that you're not supposed to bargain ("I'll rank you first if you rank me first..."), but I don't know if them just telling you frankly that they really want you and that you are at the top of their applicant pool is off limits.

These were all programs which I was interested in particularly, and I had gone out my way to maintain contact with my interviewers with letters and phone calls. So it's not like they just sat across from me at the interview and said "you're number one!" Rather, these were folks who knew me pretty well (relatively speaking)

I remember one person saying "if we're you're first choice, then this is where you'll do your residency", meaning that I had to be one of their top three for that to be true. And another just told me flat out "you're our top ranked applicant".

Despite all the rules and regulations, it's just people doing what people do.

Patience is a virtue. Virtues are strengthened - like muscles - by exercise. When you ask God for patience, he doesn't give you patience - he gives you plenty of situations in which you can exercise patience.

Residency interviews are usually very conversational. They know all your stats and scores, so they just want to visit with you, figure out what you're about, what interests you, so forth. They'll ask about your hobbies, what books you've read, your research... Usually they're pretty interested in ferreting out whether you'd be a good fit at their program - of which a million different things go into. If it's an innercity program, then: have you lived in a big city? Have you cared for an underserved population? That kind of thing. They want to figure out if you really, really want to go there, so they'll ask about what interests you in their program in particular. What do you want out of a program? What are your goals when you finish?

Stuff like that.

Most programs are gracious and welcoming - they spend a lot of time selling their program to you. A couple of the places I interviewed were sort of silly and pretentious, full of their own self importance, and I was happy to not rank them. Pay close attention to clues about how happy the residents are: the stablity of the program, the environment, examples of interaction between staff and residents, how the residents get along.

good luck!

Patience is a virtue. Virtues are strengthened - like muscles - by exercise. When you ask God for patience, he doesn't give you patience - he gives you plenty of situations in which you can exercise patience.

Patience is a virtue. Virtues are strengthened - like muscles - by exercise. When you ask God for patience, he doesn't give you patience - he gives you plenty of situations in which you can exercise patience.

Senior Member

Hey I didn't pass my anatomy the 1st semester of medschool, I extended my program (5 years of school) but did well on everything else, honored nearly every clinical rotation, 230 Step I, 259 Step II and matched without much of a problem. Don't worry about it, just don't make a habit out of messing up....meaning don't fail any of the clinical rotations, those are so much more important than the preclinical classes. Good luck.

Senior Member

Good to hear that one can match into a competitive residency like radiology even having to repeat the first year. I'm in a situation right now where it could very possibly happen, although I'm starting to get my stuff figured out and I think I can excel from here on out.

Anyway, back to HiHiHi's original question. Are there any success stories? How about details of what you actually did to turn things around, I'd be really interested in hearing.

it's a hard life...

Originally posted by orthoman5000 Anyway, back to HiHiHi's original question. Are there any success stories? How about details of what you actually did to turn things around, I'd be really interested in hearing.

I copied this answer I gave to another student who had just failed the first round of exams and was looking for advice:

During my first year of medical school, my dad was terminally ill with metastatic cancer. My concentration was so shot - I remember feeling in anatomy class as though someone had tossed a phone book into my lap and said, "here, memorize this". My performance was so poor. I failed my first two test by a slim margin, and was left needing to make a 96% on my third test just to pass the course. Of course, we don't make it into med school without some pretty remarkable test-taking skills, and I made - you guessed it - a 96% on my final.

Well, I took a year long leave of absence, took care of my dad until he died, and then returned to my second year of school a new woman. My scores were suddenly dramatically improved, putting me in the top of the class on many tests. The difference was so striking that the administration was looking into whether I had perfected the art of cheating during my absence. Nothing that easy though....I was just working my tush off.

Long and short of it....they asked me to start tutoring 'at risk' students, which I did. And I'm happy to report that the study techniques that saved my own hiney also worked to graduate every person that I worked with.

Here's what we did. You're right, you don't have time for detailed notes or flashcards. I presume that your school provides some sort of hand out or realistic length reading assignment?

* Every single weekday morning, I (and my student) would get up and ARRIVE at school at 5 am. Classes started at 8am, so that gave me 3 hours. I would read, cover to cover, the hand out for the lectures for that day. Then I would read, cover to cover, the handout for the previous day's lectures.
*Every evening after classes, I would again read, cover to cover, the handout from that days lecture, and would take the time to look up points I didn't understand, or expand on issues with textbook readings when appropriate.
Then, systematically select a prior day's lectures and read, cover to cover, the handouts from that day. Keep a log book with highlights or checkmarks so you can keep track of where you are in your review.

Here's the important thing: you have COMPLETELY reviewed each day's lectures FOUR times by doing this - just in the normal course of the day, without any cramming or additional study. You will be amazed at how much the repetition sinks things into your subconcious. When test time approaches, you are reviewing stuff that, really, you already know.

It's the consistency that does it. It was me, dragging my students out of bed, looking at their checklists, busting their buns EVERY DAY that did it. But they went from failing to, just like me, doing very, very well.

Patience is a virtue. Virtues are strengthened - like muscles - by exercise. When you ask God for patience, he doesn't give you patience - he gives you plenty of situations in which you can exercise patience.

Member

Thanks everyone...especially womansurg for the details about how you turned your life around. Even though I don't know your situation in any detail, I presume that the residency programs that were ranking you really high put aside your "bad" year, and saw the CHARACTER you showed by coming back from a devastating situation and excelling. Truly inspirational...Thank You.

I also like your early morning schedule. That way (like you said) at ~7-8 o'clock in the evening you are done for the day. That is what I miss most from my pre medical school days. I think that I will try that schedule starting next semester, and I will be sure to let you know if it works. I think the hardest thing about that schedule is getting started, but once you do it for a couple of weeks, it probably becomes routine.

it's a hard life...

Patience is a virtue. Virtues are strengthened - like muscles - by exercise. When you ask God for patience, he doesn't give you patience - he gives you plenty of situations in which you can exercise patience.

Membership Revoked

I think I am gonna try that too womansurg. Since I am already a morning person, it should not be that big of an adjustment. Thanks for the advice.

"This is grain, which any fool can eat, but for which the Lord has intended a more divine form of consumption. Let us give praise to our maker and glory to His bounty by learning about beer." - Friar Tuck

Member

yeah...that schedule is ideal for keeping up with the material. It sounds bad, but if you keep it up day in and day out, it beats the hell out of getting stressed and pissed two days before the test and thinking you are going to fail.

One realization that I have come to regarding medical school is that you control your own destiny. If you want to make all A's, I think most people can. It just takes a lot of time and effort, but it is possible for most anyone. Some students just feel that it is not their top priority to put in that much time. In other words...the most intelligent people are not the ones that are making all of the A's, it is the hardest workers that are making all of the A's.

Dr. Funk

Wow womansurg, I cannot believe someone can study that hard for an entire year.

Perhaps irrelevant to the discussion, but I usually end up attending medschool for the first month or so each year then party/sleep until end of year exams (not quite like that; we have exams every week).

Katie

I've posted this before, but my interviewing course preceptor (who was a 4th year at the time) told us that she honored 0 basic science courses during her first two years but did very well on her boards (both steps) and honored 4 clinical rotations during 3rd year. She was elected to AOA as a result of her 3rd year performance and is now a resident in OB/GYN at Yale-New Haven. Remember, P=M.D. if you're on the H/P/F system, and this does not mean you are a mediocre student to "settle" for passing, just someone who has to balance courses and having a life. And all of us, whether we like to admit it or not, sometimes have a hell of a time achieving that balance no matter what stage in the game you're at. cut yourself some slack and try to focus learning what will be important to you as a foundation for future courses and the wards. Oh yeah, second year is a lot more interesting than first IMO, it does get better. I wrote my advice for specific courses on another old thread, but if no one finds it I'd be happy to post again.

Junior Member

Once again, you dispense wonderful advice. I always enjoy reading your posts. They are refreshingly open-minded, humble, and insightful. I sure as heck haven't had a perfect performance, so hearing your story and others like it gives us average joes alot of hope. Thanks for being an inspiration to all of us still in the trenches!!!

For all you first years: hang in there!!! That first semester is pretty rough, especially if you've never had anatomy before (like me). Give it time. Most of you don't realize what you're capable of b/c you've never really been pushed to your limits yet. I didn't develop into a good student until 2nd semester 1st year. You will amaze yourself how much you will develop at learning new material. You WILL adapt. Also, like Katie said, 2nd year is alot more interesting. Instead of learning the basic sciences from PhD's, you get to learn clinical medicine from M.D.'s and D.O.'s. It's still pretty difficult though, b/c the pace goes TWICE as fast!!! It's still fun...in a sick masochistic way!!! Good Luck!

it's a hard life...

Wow, thanks to everyone for all the great positive feedback and kind words.

Originally posted by SarahL Do you have any tips for the few days before the exam, to synthesize everything you've learned? Any particular study devices that you used, like taking notes, flashcards, mnemonics, or study sheets?

I didn't have a particular system of reviewing, other than making sure that I completely read over each lecture in it's entirety one more time - which usually took a couple of days before the test. The exception might be if there were some reactions or tables, etc. that I needed to commit to memory, in which case I might make up some separate condensed notes to review.

-ws

Patience is a virtue. Virtues are strengthened - like muscles - by exercise. When you ask God for patience, he doesn't give you patience - he gives you plenty of situations in which you can exercise patience.

BlackPuma

Originally posted by Katie I've posted this before, but my interviewing course preceptor (who was a 4th year at the time) told us that she honored 0 basic science courses during her first two years but did very well on her boards (both steps) and honored 4 clinical rotations during 3rd year. She was elected to AOA as a result of her 3rd year performance and is now a resident in OB/GYN at Yale-New Haven. Remember, P=M.D. if you're on the H/P/F system, and this does not mean you are a mediocre student to "settle" for passing, just someone who has to balance courses and having a life. And all of us, whether we like to admit it or not, sometimes have a hell of a time achieving that balance no matter what stage in the game you're at. cut yourself some slack and try to focus learning what will be important to you as a foundation for future courses and the wards. Oh yeah, second year is a lot more interesting than first IMO, it does get better. I wrote my advice for specific courses on another old thread, but if no one finds it I'd be happy to post again.

Senior Member

This might be off the topic, but when sending grades to residency programs are numerical grades also reported (Eg: 78%) or just a Honors/Pass grade with appropriate interpretations (Eg: Honors in Biochem where Honors = >92%).

K

Katie

OK, as requested, here are some of the things I learned, in part from my own mistakes. I'm not going to list every course; just some of the ones that tend to cause people trouble.:

Anatomy: the best thing you can do is to look at as many cadavers as possible before the exam and look for the relevant structures. It is important to buy Netter's and Moore's for the clinical relevance that will show up on tests. Do NOT hesitate to ask for help from a tutor or from one of the professors, that is what they are there for!

Neuroscience (year 1 or year 2, depends on your school): the exam structure really differs from school to school. Make sure you go to any small group sessions or computer lab sessions that will teach you the different structures; this is very helpful.

Pharmacology: this class is much easier if you are at a school that attempts to correlate the Pharm material with what is going on in other classes. if not, it is going to be harder. It is important to keep on top of the material (some classes you can cram for, not this one!) and it helped me a great deal to make flash cards with the name of the drug on the front and class of drug, mech. of action, therapeutic indications, pharmacokinetics/metabolism, and adverse effects.

Microbiology: there is a lot of material and the challenge is to organize it so that it is easier for you to study. Either with a classmate or on your own, make an Excel chart listing each bug, morphology (Gram + or - and shape), epidemiology, mechanisms of entry, colonization, and evasion of host defenses, and clinical course of infection. If you get lucky and have classmates (bless them) who beat you to making a chart, you should be all set.

All courses listed above and all other courses: If you see a phrase while reading your syllabus/text that says something along the lines of "X is the MOST COMMON type of lung cancer" or "X is the most common infective organism in osteomyelitis", put asteriks around the phrase and know it like the back of your hand. From taking exams at 2 different medical schools and talking to various med students; I can just about assure you that this information will either show up on the exam, on the boards, or in the context of treating a patient in your future. marking off crucial information with asterisks or a different color highlighter while reading the syllabus will also help you to focus on the important material before studying for the exam instead of getting hung up on filler material.

General advice: Figure out what works for you when studying; this will probably take some time and you may never perfect it, but that doesn't mean you'll be a lousy student or bad doc! Also, if you find yourself holing up in the library until closing time every night and studying to the point where you never go out and/or never see your sig. other, family, children, friends, or pets anymore, it's probably time to reevaluate your study habits and see how you can be more efficient in the future. Oh, and figure out what lectures you need to go to and which ones you can afford to skip; this will save you a lot of time and allow you to catch up on sleep and exercise, trust me good luck!

Junior Member

After reading WomanSurg's wonderful narrative and study hints (and katie's), I just want to thank you guys for helping me out. This week has been a terrible week, and I felt for the first time this year that I REALLY didn't have what it took to be a doctor. I had a poor performance on our Histo exam (granted, I was in New Orleans over the weekend, but, oh well...) and now we have our last anatomy exam this Friday which I don't feel prepared for. Thank-you guys for helping me to realize certain things, you really helped pick this week up for me....

MM

MayoMan
"It's a funny thing about life, if we refuse to accept anything but the best we very often get it."
W. Somerset Maugham

K

Katie

you're more than welcome for the study tips; I wish someone had told me these things before starting anatomy so I wouldn't have felt so lost and overwhelmed. if any more tips come up, please post them, it could benefit all of us who are taking finals this week also, I've heard Minnesota is a great state to be in for med school and plan to apply to UMN-Twin Cities and possibly Mayo come residency time. good luck to you..

K

Katie

Originally posted by phillybabe This might be off the topic, but when sending grades to residency programs are numerical grades also reported (Eg: 78%) or just a Honors/Pass grade with appropriate interpretations (Eg: Honors in Biochem where Honors = >92%).

with the exception of Jefferson, which uses (or at least used to use) numerical grades for the first 2 years, the majority of schools do NOT report a numerical grade. If you fail a course the first time you take a course then pass it, it will NOT be marked on your transcript at Tufts that you failed the first time, and I'd guess that other schools have similar policies.

Member

Thanks for all the great advice. I had a pretty sucky semester even though I worked hard consistently throughout the semester. My main area of weakness is practicals. On both the anatomy and the histology practicals I did very poorly, even though I studied those parts extra hard. After the midterms, I had realized my weakness and so focused a lot of attention on preparing for the practicals. I wound up doing even worse on the final practicals than the midterm practicals. Is it possible that I'm unconsciously freaking out during the practicals and not thinking straight during this portion of the test. There was a 25 point discrepancy between my anatomy written grade and my anatomy practical grade. Any advice on what I should do now (also, since anatomy and histo are over, what other kinds of classes will there be practicals, besides clinical rotations?)?